Wearable Sensor-Based Real-Time Gait Detection: A Systematic Review

Abstract

Gait analysis has traditionally been carried out in a laboratory environment using expensive equipment, but, recently, reliable, affordable, and wearable sensors have enabled integration into clinical applications as well as use during activities of daily living. Real-time gait analysis is key to the development of gait rehabilitation techniques and assistive devices such as neuroprostheses. This article presents a systematic review of wearable sensors and techniques used in real-time gait analysis, and their application to pathological gait. From four major scientific databases, we identified 1262 articles of which 113 were analyzed in full-text. We found that heel strike and toe off are the most sought-after gait events. Inertial measurement units (IMU) are the most widely used wearable sensors and the shank and foot are the preferred placements. Insole pressure sensors are the most common sensors for ground-truth validation for IMU-based gait detection. Rule-based techniques relying on threshold or peak detection are the most widely used gait detection method. The heterogeneity of evaluation criteria prevented quantitative performance comparison of all methods. Although most studies predicted that the proposed methods would work on pathological gait, less than one third were validated on such data. Clinical applications of gait detection algorithms were considered, and we recommend a combination of IMU and rule-based methods as an optimal solution.

Generation of Gait Events with a FSR Based Cane Handle

“…Under this assumption, we hypothesized that the variables derived from the FSRs on the handle could not only correlate but also anticipate the signals from the other sensors. The anticipation of gait events may be critical to achieve timely stimulation in real time control or neuroprostheses or functional electrical stimulation [26] and real-time gait analysis is a key issue to control assistive devices such as prostheses and exoskeletons [3]. The conference paper in [27] confirmed our hypothesis but in a limited experiment where only one subject participates.…”

“…The main goal of this research is looking for events provided by FSRs mounted on the handle of a cane that signalize the gait and could be exploited to improve the control of prostheses or FES. Although the reliability of FSRs is low when estimating the magnitude of the force, they perform well to provide temporal information that is involved in real-time event detection [3]. Results in Figures 11-14 show many detected peaks to be used as gait events of the examined variables defined in Section 2.2.…”

“…The orientation of the segment that is tracked by the device or the angular speed and acceleration provided by the gyroscope and accelerometer of the IMU are typical inputs to this task. Some works report results that show success gait phase detection with only one IMU attached to a segment of each lower limb [3]. Gait phases are time intervals inside the gait cycle or stride that are separated by characteristic events or transitions.…”

“…However, synergy between upper and lower limbs motion can be exploited to develop better control algorithms to improve stability [20] or continuous gait performance in continuous walking [21]. The latter reported a strategy for cases where gait is impaired on one side of the body such as in hemiplegic people, the amputee, or those that suffered from stroke [3], and crutches or canes are also needed. The sensor readings from the unaffected leg of an exoskeleton can be used to control the side of the affected leg as reported in [22].…”

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

“…Prasanth et al (2021) [ 10 ] performed a systematic review of sensor-based methods applied for real-time gait analysis. Inertial measurement units on the shank and foot are most often used for gait analysis in combination with threshold or peak identification methods for gait detection.…”